To B or not to B (Part B + Federal BCBS)

[Helen]

I am a retired Federal employee on Federal BCBS Basic. I turned 65 a few weeks ago. My spouse is on my insurance (self + 1) and will turn 65 this Fall.

I have been on BCBS Basic for 25+ years. I had a brain aneurysm procedure in 2002, I don't recall what it cost out of pocket, but it wasn't bad. I have had three colonoscopies which again cost very little. Three years ago I had my appendix removed and that cost me $300 plus a $30 copay and two years ago I had a pre-cancerous thingie removed from my eye which cost $400 plus a $40 copay.

I have only had one doctor who didn't accept BCBS in 25+ years; BCBS Basic has served me well.

I have read the past posts on here and FedSoup et al regarding the decision to pick up Medicare Part B or not. I also read the Checkbook Guide to Health Plans for Federal Employees (they recommend not picking Part B up).

My BCBS coverage so far has been excellent so I am not sure paying for the Part B premium will be worth it.

If we don't do any Roth conversions our Part B premiums will be $170 per month minus the BCBS kickback of $800 per year. 170*12 = $2040 - $800 = $1,240 x 2 = $2,480 per year in Part B premiums for both of us.

By age 70, when Social Security begins, We will be in the $238 per month premium due to IRMAA. $238*12 = $2,856 - $800 = $2,056 x 2 = $4,112 per year for both of us. Once the RMDs begin at age 72 we will be well within the higher premium of $238 per month per person.

I guess it boils down to: Is it worth it to pay $4,112 per year in Part B premiums to avoid paying up to the $13,000 out of pocket max for the years we are in really bad health?

Does anyone have any input on how to decide what to do? I obviously have analysis paralysis.

 

[W2R]

I don't know the answers. I am a retired federal employee with BCBS Standard, which is $276.19/month, even more expensive than BCBS Basic. My Part B is also $238 due to IRMAA, just like yours might be.

Still, I'll be 74 years old in 9 days, and for me at this age, it's just one health problem after another. (I can hear a chorus of our older forum members saying in unison "Yeah, TELL me about it!" ). Having Part B has been comforting, because I know that I have done all I can to minimize unexpected huge health care costs.

For example last year I was hit with severe COVID double pneumonia unexpectedly while evacuating from Hurricane Ida, and ended up in an ICU in Arkansas for about two weeks or so. The charges added up to a frighteningly high total that kept increasing every time I checked my email (after I recovered). But they saved my life. Despite being unable to figure out my finances at all for several months due to severe Covid brain fog I still felt fairly sure that I'd be OK financially afterwards. That was worth every penny I spent on BCBS+Part B.

I admit that I am not good with understanding insurance, or legal stuff either. Just not something I'm good at. It does seem like a lot in monthly costs for Part B + BCBS, but I still have enough for other expenses. If I was barely scraping by I might make different choices.

 

[Golden sunsets]

We too use our FEHB plus Part B. We also pay IRMAA and may jump into the 3rd tier some year soon. We happen to have Aetna Direct rather than BCBS Basic, but aside from the small premium difference between Aetna and BCBS Basic($345/mo vs $425/mo. for self +1), plus the slightly higher reimbursement from Aetna ($900pp rather than $800pp) it works the same for us as it would for you.

Keep in mind that if you have both, your FEHB waives all copays and deductibles(except prescription copays)that you will have to pay if you skip Part B, so the net cost is even less.

Also if you don't sign up and and down the road change your mind, the cost will be even greater, due to the delay penalty assessed. Literally the only costs we have other than premiums is prescription copays, which are $2 per prescription for a 90 day supply.

One other thought. If you have both, (at least with Aetna Direct) you can use any doc, even if they are out of network, and as long as the provider accepts Medicare your FEHB covers you as if you are in network.

 

[Montecfo]

There are free counselors available in every state who can help you figure out which flavor of medicare. It is through HHS. Often the acronym is SHIP. If you google that and your state you will find some useful free help.

 

[teej1985]

We too use our FEHB plus Part B. We also pay IRMAA and may jump into the 3rd tier some year soon. We happen to have Aetna Direct rather than BCBS Basic, but aside from the small premium difference between Aetna and BCBS Basic($345/mo vs $425/mo. for self +1), plus the slightly higher reimbursement from Aetna ($900pp rather than $800pp) it works the same for us as it would for you.

Keep in mind that if you have both, your FEHB waives all copays and deductibles(except prescription copays)that you will have to pay if you skip Part B, so the net cost is even less.

Also if you don't sign up and and down the road change your mind, the cost will be even greater, due to the delay penalty assessed. Literally the only costs we have other than premiums is prescription copays, which are $2 per prescription for a 90 day supply.

One other thought. If you have both, (at least with Aetna Direct) you can use any doc, even if they are out of network, and as long as the provider accepts Medicare your FEHB covers you as if you are in network.

The biggest difference is that Aetna Direct will pay the leftover balance after Medicare for any doctor that accepts Medicare, BCBS Basic only pays for those that are in the BCBS network. Prescription coverage would be the other potentially large difference.

 

[militaryman]

Anyone out there have available FEHB and Tricare and elect to suspend FEHB and just use Tricare prime/select and part B? Is it as comprehensive as say Aetna and part B or bcbs basic and part B?

 

[teej1985]

Anyone out there have available FEHB and Tricare and elect to suspend FEHB and just use Tricare prime/select and part B? Is it as comprehensive as say Aetna and part B or bcbs basic and part B?

I'm not sure why you'd bother with FEHB if you have Medicare and Tricare.

I guess if you were hit with massive IRMAA you might opt for FEHB instead.

 

[Helen]

This is kind of weird, are they trying to assess whether the person still has their marbles?

You can voluntarily terminate your Medicare Part B (medical insurance). However, since this is a serious decision, you may need to have a personal interview. A Social Security representative will help you complete Form CMS 1763. To find out more about how to terminate Medicare Part B or to schedule a personal interview, contact us at 1-800-772-1213 (TTY: 1-800-325-0778) between Monday through Friday from 8:00 am – 7:00 pm. You can also contact your nearest Social Security office.

Serious stuff, Form CMS 1763 requires two witnesses who know the person who is dropping Medicare.

 

[Lakedog]

I had this decision to make last year and did sign up for Medicare part b since I was aware that I could drop part b anytime. I am on the GEHA standard plan ($135.77 per month) and so far it has paid all costs not covered by medicare. From a strictly cost viewpoint, skipping Medicare part b is the recommendation of the the guy (Walt Francis) who puts out the Checkbook Guide to health plans for Federal employees.

Paying higher part b costs due to IRMAA is the reason I may decide to drop it at some point in the future.

 

[Dreamer]

We had Federal Blue Cross/Blue Shield Standard and Medicare when we turned 65. I read more and talked with other Fed retirees and last year, I changed BC/BS to Basic. So far, we have not had any problems.

My DH has to get colonoscopies more frequently and was diagnosed with Prostrate cancer this year. He had to have an MRI for it and a biopsy, but we have not had to pay anything yet. In 2018 I went to the hospital and an emergency surgery was performed. I also had sepsis. I was in the hospital for a couple of days and everything was paid by Medicare and insurance.

I am another person not wanting to worry about health expenses as we get older.

 

[donheff]

I’m 73 and have been on GEHA with no Part B for almost 9 years. I have had a few major surgeries in that period and am still confident I made the right decision to skip Part B. Like you, our IRMA hits would make B a costly proposition. I live in DC where GEHA has a network that is pretty much the same as BCBS for quite a bit less. I would look at the network coverage if I moved and might switch back to BC.

I think the average Fed goes with Part B because they want rhe maximum coverage they can get and doesn’t’t consider the likely cost savings from skipping B